Traditional enemy of free speech. This is a work of fiction. Names, characters, places, incidents and circumstances are a product of the author's imagination. Any similarity to people, dead or alive, to events or places, is entirely accidental.

Monday, February 12, 2007

Bad Science

The 'Bad Science' column in the Guardian is always good, but this week's one really takes its target, 'Dr' Gillian MacKeith, to pieces. Here's part of it (the whole thing is here)

In reality, again, away from the cameras, the most significant "lifestyle" cause of death and disease is social class. Here's a perfect example. I rent a flat in London's Kentish Town on my modest junior doctor's salary (don't believe what you read in the papers about doctors' wages, either). This is a very poor working-class area, and the male life expectancy is about 70 years. Two miles away in Hampstead, meanwhile, where the millionaire Dr Gillian McKeith PhD owns a very large property, surrounded by other wealthy middle-class people, male life expectancy is almost 80 years. I know this because I have the Annual Public Health Report for Camden open on the table right now.

This phenomenal disparity in life expectancy - the difference between a lengthy and rich retirement, and a very truncated one indeed - is not because the people in Hampstead are careful to eat a handful of Brazil nuts every day, to make sure they're not deficient in selenium, as per nutritionists' advice.

And that's the most sinister feature of the whole nutritionist project, graphically exemplified by McKeith: it's a manifesto of rightwing individualism - you are what you eat, and people die young because they deserve it. They choose death, through ignorance and laziness, but you choose life, fresh fish, olive oil, and that's why you're healthy. You're going to see 78. You deserve it. Not like them.

How can I be sure that this phenomenal difference in life expectancy between rich and poor isn't due to the difference in diet? Because I've read the dietary intervention studies: when you intervene and make a huge effort to change people's diets, and get them eating more fruit and veg, you find the benefits, where they are positive at all, are actually very modest. Nothing like 10 years.

But genuine public health interventions to address the real social and lifestyle causes of disease are far less lucrative, and far less of a spectacle, than anything a food crank or a TV producer would ever dream of dipping into. What prime-time TV series looks at food deserts created by giant supermarket chains, the very companies with which stellar media nutritionists so often have lucrative commercial contracts? What show deals with social inequality driving health inequality? Where's the human interest in prohibiting the promotion of bad foods; facilitating access to nutrient-rich foods with taxation; or maintaining a clear labelling system? Where is the spectacle in "enabling environments" that naturally promote exercise, or urban planning that prioritises cyclists, pedestrians and public transport over the car? Or reducing the ever-increasing inequality between senior executive and shop-floor pay?

This is serious stuff. We don't need any more stupid ideas about health in the world. We have a president of South Africa who has denied that HIV exists, we have mumps and measles on the rise, we have quackery in the ascendant like never before, and whatever Tony Blair might have to say about homoeopathy being a fight not worth fighting for scientists, we cannot indulge portions of pseudoscientific ludicrousness as if they don't have wider ramifications for society, and for the public misunderstanding of science.

I am writing this article, sneakily, late, at the back of the room, in the Royal College of Physicians, at a conference discussing how to free up access to medical academic knowledge for the public. At the front, as I type, Sir Muir Gray, director of the NHS National Electronic Library For Health, is speaking: "Ignorance is like cholera," he says. "It cannot be controlled by the individual alone: it requires the organised efforts of society." He's right: in the 19th and 20th centuries, we made huge advances through the provision of clean, clear water; and in the 21st century, clean, clear information will produce those same advances.

1 Comments:

It's also worth noting that dietary habits are often rational decisions made as a result of work practices and payscales. A 99p takeaway burger provides a lot more energy for your money (& quicker release too) than a cashew-nut and avocado panini. And who wants to cook for themselves after a twelve-hour shift? Better to put a curry in the microwave.